Individual
IRWIN RANDELL COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4006 DUTCHMANS LN, SUITE 100, LOUISVILLE, KY 40207-4704
(502) 873-7517
Mailing address
4307 GLENARM RD, CRESTWOOD, KY 40014-9586
(502) 241-2892
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
29908
KY
2085R0202X
Diagnostic Radiology Physician
2011000734
MO
2085R0202X
Diagnostic Radiology Physician
29908
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200165860
—
IN
05
—
64299084
—
KY
Enumeration date
06/13/2005
Last updated
02/18/2013
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